AccountId: 011433970860
ContactId: f026859a-1b67-4dbb-bab6-3f0ae21ff0f1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155300 ms
Total Talk Time (AGENT): 76008 ms
Total Talk Time (CUSTOMER): 62959 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/f026859a-1b67-4dbb-bab6-3f0ae21ff0f1_20250422T12:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from provider's office. I'm calling to see if you could help me out with the gap coverage for one of my patients.
[AGENT][NEUTRAL] I'm sure, [PII] I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Of course [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Yes, the policy number I have here on file.
[CUSTOMER][NEUTRAL] It will be 02216489 M as in Mary, L as in Larry, S as in Sam, and the number 8.
[AGENT][NEUTRAL] OK, thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK. And just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII]. The policy is still active, and is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, for outpatient.
[AGENT][NEUTRAL] OK, let's see. For outpatient, we cover up to $200 per day and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, so the patient is coming in today to have a procedure done. um, would you be able to help me out if I provide you with the CPT code?
[AGENT][NEUTRAL] Well, we're secondary insurance, um, so we go by the primary, um, insurance carriers.
[AGENT][NEUTRAL] Um, guidelines.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, so if they cover it, then we'll cover our portion, right?
[CUSTOMER][NEUTRAL] OK, OK, so just, OK, so to be clear.
[CUSTOMER][POSITIVE] Oh, OK, OK, oh, OK, fantastic. Can I, can I please have a reference number for this call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII] um it's spelled [PII] Last initial is [PII], and today's date for the reference number. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that'll be and that'll be all. Thank you very much. Have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright bye bye.